MEDICARE: TOSHA S MORRIS STNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	400327060204	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2697907	OTHER	OH	STNA

General Provider Information

NPI Number	:	1194945576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOSHA S MORRIS STNA

Provider Business Mailing Address
First Line	:	14163 US HWY 52
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663
Country	:	US
Telephone Number	:	740-250-2106
Fax Number	:

Provider Business Practice Location Address
First Line	:	14163 US HIGHWAY 52
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-9095
Country	:	US
Telephone Number	:	740-250-2106
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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Directions to “ TOSHA S MORRIS STNA” Practice Location

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